Cargando…

Myelomeningocele Surgery over the 10 Years Following the MOMS Trial: A Systematic Review of Outcomes in Prenatal versus Postnatal Surgical Repair

Background and Objectives: Myelomeningocele is the most severe form of spina bifida, a congenital neural tube defect arising from an incomplete neural tube closure during early development with damage worsening with advancing gestational age. The Management of Myelomeningocele Study (MOMS) Trial pro...

Descripción completa

Detalles Bibliográficos
Autores principales: Paslaru, Francesca Gabriela, Panaitescu, Anca Maria, Iancu, George, Veduta, Alina, Gica, Nicolae, Paslaru, Alexandru Catalin, Gheorghiu, Anamaria, Peltecu, Gheorghe, Gorgan, Radu Mircea
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8307221/
https://www.ncbi.nlm.nih.gov/pubmed/34356988
http://dx.doi.org/10.3390/medicina57070707
_version_ 1783727998591041536
author Paslaru, Francesca Gabriela
Panaitescu, Anca Maria
Iancu, George
Veduta, Alina
Gica, Nicolae
Paslaru, Alexandru Catalin
Gheorghiu, Anamaria
Peltecu, Gheorghe
Gorgan, Radu Mircea
author_facet Paslaru, Francesca Gabriela
Panaitescu, Anca Maria
Iancu, George
Veduta, Alina
Gica, Nicolae
Paslaru, Alexandru Catalin
Gheorghiu, Anamaria
Peltecu, Gheorghe
Gorgan, Radu Mircea
author_sort Paslaru, Francesca Gabriela
collection PubMed
description Background and Objectives: Myelomeningocele is the most severe form of spina bifida, a congenital neural tube defect arising from an incomplete neural tube closure during early development with damage worsening with advancing gestational age. The Management of Myelomeningocele Study (MOMS) Trial proved that surgery performed before 26 weeks of gestation significantly improved the prognosis, significantly changing treatment paradigms. This article aims to provide a review of the changes and updates in spina bifida repair over the 10-year period following the MOMS Trial. Material and methods: We performed a systematic review in the PubMed and Cochrane databases as well as a hand-search of high-impact journals using the reference list of all identified articles, searching for randomized controlled trials and observational studies. Results: We identified 27 articles published between 2011 and 2021 that fulfilled the inclusion criteria and review them in the present study. Conclusions: With growing experience and with the improvement of prenatal open and fetoscopic techniques, the outcome of SB-associated conditions could be improved and the risks to both the mother and the fetus reduced. A continuous follow-up of the treated infants and further randomized trials are essential to study the complications and advantages or disadvantages of any given treatment strategy.
format Online
Article
Text
id pubmed-8307221
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-83072212021-07-25 Myelomeningocele Surgery over the 10 Years Following the MOMS Trial: A Systematic Review of Outcomes in Prenatal versus Postnatal Surgical Repair Paslaru, Francesca Gabriela Panaitescu, Anca Maria Iancu, George Veduta, Alina Gica, Nicolae Paslaru, Alexandru Catalin Gheorghiu, Anamaria Peltecu, Gheorghe Gorgan, Radu Mircea Medicina (Kaunas) Systematic Review Background and Objectives: Myelomeningocele is the most severe form of spina bifida, a congenital neural tube defect arising from an incomplete neural tube closure during early development with damage worsening with advancing gestational age. The Management of Myelomeningocele Study (MOMS) Trial proved that surgery performed before 26 weeks of gestation significantly improved the prognosis, significantly changing treatment paradigms. This article aims to provide a review of the changes and updates in spina bifida repair over the 10-year period following the MOMS Trial. Material and methods: We performed a systematic review in the PubMed and Cochrane databases as well as a hand-search of high-impact journals using the reference list of all identified articles, searching for randomized controlled trials and observational studies. Results: We identified 27 articles published between 2011 and 2021 that fulfilled the inclusion criteria and review them in the present study. Conclusions: With growing experience and with the improvement of prenatal open and fetoscopic techniques, the outcome of SB-associated conditions could be improved and the risks to both the mother and the fetus reduced. A continuous follow-up of the treated infants and further randomized trials are essential to study the complications and advantages or disadvantages of any given treatment strategy. MDPI 2021-07-12 /pmc/articles/PMC8307221/ /pubmed/34356988 http://dx.doi.org/10.3390/medicina57070707 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Systematic Review
Paslaru, Francesca Gabriela
Panaitescu, Anca Maria
Iancu, George
Veduta, Alina
Gica, Nicolae
Paslaru, Alexandru Catalin
Gheorghiu, Anamaria
Peltecu, Gheorghe
Gorgan, Radu Mircea
Myelomeningocele Surgery over the 10 Years Following the MOMS Trial: A Systematic Review of Outcomes in Prenatal versus Postnatal Surgical Repair
title Myelomeningocele Surgery over the 10 Years Following the MOMS Trial: A Systematic Review of Outcomes in Prenatal versus Postnatal Surgical Repair
title_full Myelomeningocele Surgery over the 10 Years Following the MOMS Trial: A Systematic Review of Outcomes in Prenatal versus Postnatal Surgical Repair
title_fullStr Myelomeningocele Surgery over the 10 Years Following the MOMS Trial: A Systematic Review of Outcomes in Prenatal versus Postnatal Surgical Repair
title_full_unstemmed Myelomeningocele Surgery over the 10 Years Following the MOMS Trial: A Systematic Review of Outcomes in Prenatal versus Postnatal Surgical Repair
title_short Myelomeningocele Surgery over the 10 Years Following the MOMS Trial: A Systematic Review of Outcomes in Prenatal versus Postnatal Surgical Repair
title_sort myelomeningocele surgery over the 10 years following the moms trial: a systematic review of outcomes in prenatal versus postnatal surgical repair
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8307221/
https://www.ncbi.nlm.nih.gov/pubmed/34356988
http://dx.doi.org/10.3390/medicina57070707
work_keys_str_mv AT paslarufrancescagabriela myelomeningocelesurgeryoverthe10yearsfollowingthemomstrialasystematicreviewofoutcomesinprenatalversuspostnatalsurgicalrepair
AT panaitescuancamaria myelomeningocelesurgeryoverthe10yearsfollowingthemomstrialasystematicreviewofoutcomesinprenatalversuspostnatalsurgicalrepair
AT iancugeorge myelomeningocelesurgeryoverthe10yearsfollowingthemomstrialasystematicreviewofoutcomesinprenatalversuspostnatalsurgicalrepair
AT vedutaalina myelomeningocelesurgeryoverthe10yearsfollowingthemomstrialasystematicreviewofoutcomesinprenatalversuspostnatalsurgicalrepair
AT gicanicolae myelomeningocelesurgeryoverthe10yearsfollowingthemomstrialasystematicreviewofoutcomesinprenatalversuspostnatalsurgicalrepair
AT paslarualexandrucatalin myelomeningocelesurgeryoverthe10yearsfollowingthemomstrialasystematicreviewofoutcomesinprenatalversuspostnatalsurgicalrepair
AT gheorghiuanamaria myelomeningocelesurgeryoverthe10yearsfollowingthemomstrialasystematicreviewofoutcomesinprenatalversuspostnatalsurgicalrepair
AT peltecugheorghe myelomeningocelesurgeryoverthe10yearsfollowingthemomstrialasystematicreviewofoutcomesinprenatalversuspostnatalsurgicalrepair
AT gorganradumircea myelomeningocelesurgeryoverthe10yearsfollowingthemomstrialasystematicreviewofoutcomesinprenatalversuspostnatalsurgicalrepair